Clinical Quality Analyst - Remote in VA Market Only

Lensa; Richmond (VA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company in the healthcare industry is seeking a Clinical Quality Analyst for a remote position tailored for candidates in Virginia. This role involves conducting quality management reviews and supporting healthcare providers with necessary guidance and education. Successful candidates will require a degree in health-related fields and experience in corresponding roles, as well as proficiency in MS Office applications.

Benefits

Comprehensive benefits package

Equity stock purchase

401k contribution

Qualifications

• 2+ years of direct experience in healthcare is required.
• 1+ years of experience with MS Office, including Word, Excel, and Outlook.

Responsibilities

• Conduct quarterly onsite quality management reviews for HCBS waivers.
• Determine if services were delivered in accordance with the service plan.
• Provide ongoing education and support to providers.

Skills

MS Office

Education

4-year Degree in a health-related field

Job description

Clinical Quality Analyst - Remote in VA Market Only

Clinical Quality Analyst - Remote in VA Market Only

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Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

While this is a Remote opportunity in the state of VA, the role does require travel for a minimum of 1 week per quarter.

If you reside within the state of VA, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

• Conduct quarterly onsite quality management reviews for the HCBS waivers and programs as assigned by our state partner
• Determine if services were delivered in accordance with the service plan
• Conduct follow up reviews as needed based on results from initial reviews (may be onsite or virtual)
• Discuss QMR details with providers
• Assist providers with development of action plans
• Provide ongoing education and support to providers and internally on the QMR process and waiver services processesMaintain and submit quarterly reporting for state partner
• Collaborate with Provider Advocates, Networking, and Service Integrity Unit as needed
• Ongoing collaboration and training with state partner
• Remain up to date with provider manuals and state regulations
  
  

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• 4-year or Higher Degree in a health-related field (e.g., psychology, counseling, etc.) and 2+ years of direct experience
• 1+ years of experience with MS Office, including Word, Excel, and Outlook
  
  

Preferred Qualifications

• Experience working in team-based care
• Experience working with Virginia Medicaid
• Experience working with Long-term care individuals
• Background in Managed Care
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far- reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  IT Services and IT Consulting

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